A Comparison between Dry and Moistened Intravaginal Misoprostol
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- Category: Vol. 77, June 2009
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A Comparison between Dry and Moistened Intravaginal Misoprostol for Termination of Second Trimester Pregnancy: A Randomized Comparative Trial,AHMAD M. ABU EL-HASAN, AHMAD I. HASANIN, MOHAMAD S. ABDELLAH, MOHAMAD M. FATAHALAH and MUSTAFA HUSSIEN
Abstract
Background: This study was conducted to evaluate the efficacy and safety of 200 μg misoprostol administered vag-inally every 4 hours to a maximum of 48 hours for second trimester intrauterine fetal death.
Methods: We conducted a prospective, randomized trial comparing the efficacy and safety of misoprostol, a synthetic analoge of prostaglandin El "alprostadil", (200 μg intravagi-nally every 4 hours) either in its dry form (group A) or moistened with 1 ml of saline (group B). The study population included 136 pregnant women between 14 and 24 weeks' gestation who were seeking for termination of pregnancy because of intrauterine fetal death.
Setting: Woman's Health Center, Assiut University.
Results: All patients in both groups aborted within 48 hours (100% success rate), the median induction-abortion interval was significantly shorter in group B than in group A (p<0.01) patients in group B had significantly short median induction-abortion interval (p<0.01), less total numbers of doses (p<0.05), less retained placenta (p<0.05), more abortion within 24 hours (p<0.01), more abortion with the 1st dose (p<0.01), but had more need for analgesia and more incidence of side effects (p<0.01).
Conclusions: The intravaginal administration of 200 μg of misoprostol tablet moistened with saline every 4 hours was effective for second trimester pregnancy termination and superior to dry misoprostol tablet. However, it was associated with more side effects which were well tolerated.